The benefits of medication in the long term treatment of schizophrenia - reduced risk of relapse, reduction of psychopathology - are well established. However, concern about the risk of tardive dyskinesia and the relative lack of improvement of social functioning have led to attempts to improve upon standard prophylactic treatment. The investigation's goal is to test the efficacy of three drug maintenance strategies and their relationship to psychosocial management strategies in patients with schizophrenia. Specifically, the effects of (1) continuous low dose, (2) discrete targeted early intervention, or (3) continuous standard dose antipsychotic drug treatment, each in combination with either (1) applied or (2) supportive family management, on schizophrenic patients in the community will be examined in terms of prevention of relapse, maintenance of remission, further reduction of psychopathology, improvement in social functioning, and reduction of side effects. Patients will be randomly assigned to these treatments resulting in a complete 3 x 2 factorial design. Combined treatment will continue for a one year period followed by an additional one year of treatment with the drug maintenance strategies alone. The investigation's design requires a multicenter collaborative study to permit generalization of findings to a range of treatment settings and to provide an adequate number of cases to test the hypothesis.
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